Key result
Depression increased the risk of incident hypertension by 24% (HR 1.24) compared to no depressive symptoms, and this risk was significantly amplified when coexisting with obesity.
Why the study?
The impact of depressive status on hypertension incidence remains controversial and had not been studied in the Chinese middle-aged and elderly population.
Does depressive status and higher body mass index increase the risk of incident hypertension in a Chinese middle-aged and elderly population?
Cohort (n=11,050)
Yes
Does depressive status and higher body mass index increase the risk of incident hypertension in a Chinese middle-aged and elderly population?
Hazard Ratio: 1.24 (95% CI 1.03–1.5)
Absolute Event Rate: 10.5% vs 8.6%
Depressive status increases the risk of incident hypertension in aging populations, an effect that is significantly amplified by coexisting overweight or obesity.
DS was associated with incident hypertension, amplified by higher BMI; leaves open whether depression screening or treatment prevents hypertension in aging Chinese adults.
BACKGROUND: The impact of depressive status (DS) on hypertension incidence is still controversial and has not been studied in Chinese middle-aged and elderly population. This study aimed to explore the relationship between DS and incident hypertension and analyze the joint effects of DS and body mass index (BMI) on hypertension incidence. METHODS: We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide population-based study. In 2013, DS was identified using scores from the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) among eligible respondents from CHARLS, and hypertension occurrence was observed until 2018. The multiple Cox models were employed to calculate the associations between DS and hypertension incidence. In addition, we also computed the multiplicative interaction (MI) between DS and BMI of incident hypertension and assessed their additive interaction (AI) through relative excess risk due to interaction (RERI), attributable proportion (AP) or synthetic index (S). Positive AI was indicated by RERI > 0, AP > 0 or S > 1. RESULTS: Over the 5-year follow-up, depressive symptoms increased the risk of hypertension incidence by 19% (hazard ratio (HR) = 1.19, 95% confidence interval (CI): (1.01, 1.41)), while depression was associated with a 24% increased risk (HR = 1.24; 95% CI: (1.03, 1.50)). Significant MIs between DS and overweight or obesity were observed and almost all of AI indexes showed positive joint effects on incident hypertension, of which the depression-obesity combination had the largest joint effect (RERI = 4.47, 95%CI: (0.28, 8.66); AP = 0.67, 95%CI: (0.50, 0.85); S = 4.86,95%CI: (2.66, 8.86)). CONCLUSION: DS could lead to hypertension and this impact was amplified when coexisting with higher BMI. It highlighted a need for precise interventions targeting weight management and depression treatment in the aging population to prevent hypertension.
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Luo et al. (2023) conducted a cohort in Hypertension (n=11,050). Depression vs. No depressive symptoms was evaluated on Incidence of hypertension (HR 1.24, 95% CI 1.03, 1.50). Depression increased the risk of incident hypertension by 24% (HR 1.24) compared to no depressive symptoms, and this risk was significantly amplified when coexisting with obesity.
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